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KMID : 0376219770140020347
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Chonnam Medical Journal
1977 Volume.14 No. 2 p.347 ~ p.357
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Fiberoptic Examination of the Esophageal Diseases
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Abstract
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A flexible fiberscope for the observation of the esophagus was introduced in 1964. Improved efficiency and safety in this field have justified some extention of the indications for employing esophagoscopic examinations in recent years.
Illustration of the flexible fiberoptic pan-view scope, details of the operating procedure- and 67 cases with disorders in the esophagus during the period of two years from January, 1976 through December, 1977 were presented.
In 67 cases with flexible fiberscopic examinations including photography and punch biopsy under direct vision, the following diagnosis was made : 35 cases. of esophageal cancer; 11 cases. of esophagitis, 6 cases of achalasia, 2 cases of esophageal diverticulum, 1 case of esophageal tuberculosis, 1 case of esophageal varix and 11 cases of normal examination. Ages of the patients diagnosed were 21 to 75.
There was no grave complication such as perforation of the esophagus, acute myocardial infarction, severe hemorrhage and fatal bacteremia but in several cases severe abdominal pain and distension so-called pseudoacute abdomen due to air filling in the small intestine were encountered.
Among the esophageal cancer patients, there were 27 males and 8 females, showing the ratio of 3.3: 1.
The majority of the patients were found from the age of 41 to 70. The cardinal symptoms of them were dysphagia (65.7%), weight loss (60%) and vomiting (45.7% ).
The esophageal cancer was located at the middle third segment in 12 cases (34.3 % ), ,at the lower third segment in 20 (57.1 %) and at the middle and lower third segments in 3 (8.6% ).
Histologically, 25 cases (71.4%) were accounted as, squamous cell carcinoma, 8 cases(22.9%) as adenocarcinoma´ which were mostly located at the lower segment` and 2 cases (5.7%) as mucinous cell carcinoma.
Macroscopically, most of the squamous cell carcinoma revealed tumorous or polypoid type.
A patient with 2-week history of dysphagia and substernal pain, who had been suspected of esophageal cancer by esophagogram, was proved to be rare esophageal tuberculosis endoscopically.
Whenever roentgenographic examinations were normal barium swallow, esophagoscopic studies facilitated to diagnose fine lesion such as esophagitis, varix and functional disorders.
We are convinced that the success of fiberscopic esophagoscopy has increased diagnostic accuracy on esophageal diseases and postoperative anastomotic condition as X-ray examinations do and that esophagoscope will be widely utilized for the therapeutic and other special employments such as endoscopic polypectomy, removal of foreign bodies, removal of the remaining surgical suture, widening of the cicatrical stricture of anastomotic site, marking in the esophagus using the small metal tips, and local therapy of the esophageal cancer with anti-cancer drugs.
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